• Title/Summary/Keyword: Systematic diagnosis

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Association of Knowledge and Cultural Perceptions of Malaysian Women with Delay in Diagnosis and Treatment of Breast Cancer: a Systematic Review

  • Khan, Tahir Mehmood;Leong, Jamie Pik Yan;Ming, Long Chiau;Khan, Amer Hayat
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.13
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    • pp.5349-5357
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    • 2015
  • Background: Breast cancer is the most common cancer and the leading cause of cancer mortality among women of all ethnic and age groups in Malaysia. Delay in seeking help for breast cancer symptoms is preventable and by identifying possible factors for delayed diagnosis, patient prognosis and survival rates could be improved. Objectives: This narrative review aimed to understand and evaluate the level of in-depth breast cancer knowledge in terms of clinical breast examination and breast self-examination, and other important aspects such as side-effects and risk factors in Malaysian females. Since Malaysia is multicultural, this review assessed social perceptions, cultural beliefs and help-seeking behaviour in respect to breast cancer among different ethnic groups, since these may impinge on efforts to 'avoid' the disease. Materials and Methods: A comprehensive literature search of seven databases was performed from December 2015 to January 2015. Screening of relevant published journals was also undertaken to identify available information related to the knowledge, perception and help-seeking behaviour of Malaysian women in relation to breast cancer. Results: A total of 42 articles were appraised and included in this review. Generally, women in Malaysia had good awareness of breast cancer and its screening tools, particularly breast self-examination, but only superficial in-depth knowledge about the disease. Women in rural areas had lower levels of knowledge than those in urban areas. It was also shown that books, magazines, brochures and television were among the most common sources of breast cancer information. Delay in presentation was attributed mainly to a negative social perception of the disease, poverty, cultural and religion practices, and a strong influence of complementary and alternative medicine, rather than a lack of knowledge. Conclusions: This review highlighted the need for an intensive and in-depth breast cancer education campaigns using media and community health programmes, even with the existing good awareness of breast cancer. This is essential in order to avoid misconceptions and to frame the correct mind-set about breast cancer among women in Malaysia. Socio-cultural differences and religious practices should be taken into account by health care professionals when advising on breast cancer. Women need to be aware of the risk factors and symptoms of breast cancer so that early diagnosis can take place and the chances of survival improved.

Risk of Breast Cancer and Total Malignancies in Rheumatoid Arthritis Patients Undergoing TNF-α Antagonist Therapy: a Meta-analysis of Randomized Control Trials

  • Liu, Yang;Fan, Wei;Chen, Hao;Yu, Ming-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3403-3410
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    • 2014
  • Context: Interest exits in whether TNF-alpha antagonists increase the risk of breast cancer and total malignancies in patients with rheumatoid arthritis (RA). Objectives: To analyze the risk of malignancies, especially breast cancer, in patients with RA enrolled in randomized control trials (RCTs). Methods: A systematic literature search for RCTs from 1 January 1998 to 1 July 2013 from online databases, such as PubMed, WILEY, EMBASE, ISI web of knowledge and Cochrane Library was conducted. Studies included RCTs that compared the safety of at least one dose of the five TNF-${\alpha}$ antagonists with placebo or methotrexate (MTX) (or TNF-${\alpha}$ antagonists plus MTX vs placebo plus MTX) in RA patients for more than 24 weeks and imported all the references into document management software EndNote${\times}6$. Two independent reviewers selected studies and extracted the data about study design, patients' characteristics and the type, number of all malignancies. Results: 28 RCTs from 34 records with 11,741 patients were analyzed. Of the total, 97 developed at least one malignancy during the double-blind trials, and breast cancer was observed in 17 patients (17.5% of total malignancies). However, there was no statistically significant increased risk observed in either the per protocol (PP) model (OR 0.65, 95%CI [0.22, 1.93]) or the modified intention to treat (mITT) model (OR 0.75, 95%CI [0.25, 2.21]). There were also no significant trend for increased risk of total malignancies on anti-TNF-${\alpha}$ therapy administered at approved doses in either model (OR, 1.06, 95%CI [0.64, 1.75], and OR, 1.30, 95%CI [0.80, 2.14], respectively). As to the two models, modified intention to treat model analysis led to higher estimation than per protocol model analysis. Conclusions: This study did not find a significantly increased risk of breast cancer and total malignancies in adults RA patients treated with TNF-${\alpha}$ antagonists at approved doses. However, it cannot be ignored that more patients developed malignancies with TNF-${\alpha}$ antagonists therapy compared with patients with placebo or MTX, in spite of the lack of statistical significance, so that more strict clinical trials and long-term follow-up are needed, and both mITT and PP analyses should be used in such safety analyses.

Comparison Between Ultrasonic and X-ray Methods for Imaging the Children′s Growth Plate (어린이 성장판 영상화를 위한 초음파와 X-선 방식의 비교 평가)

  • Kim Sang Hoo;Kim Hyung Jun;Han Eun Ok;Han Seung Moo
    • Journal of Biomedical Engineering Research
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    • v.25 no.6
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    • pp.551-556
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    • 2004
  • The purpose of this study was to suggest a systematic and scientific method for measurement of children's growth development, in which the accuracy of existing diagnosis method has not been concretely examined yet. The most popular method for diagnosis of children's growth is to analyze the opening degree of growth plate in each joint by X-ray image. However, X-ray method has some disadvantages; it is impossible to measure the diagnosis of growth periodically and repeatedly due to the radiation problem. Hence, this study introduced a profile analysis and the algorithm of analyzing the image of growth plate with the BUA(Broadband Ultrasound Attenuation) of calcaneus, to verify the possibility of alternative ultrasonic method harmless to human body. We obtained the images of growth plate in proximal tibiae, phalanges, and calcanei of 269 children (7∼16 years old) with X-ray. And the image of growth plate in calcanei was also obtained front those children with ultrasound. The results showed that the time of the opening degree of growth plate in each joint was almost consistent between X-ray and ultrasonic images. Also, the images of growth plate measured by X-ray and ultrasound showed the high correlation. Therefore, it is expected that the algorithm of ultrasonic profile analysis introduced in this study can replace the existing X-ray method to measure the growth plate correctly.

A study of Korean medical knowledge system which Korean medical doctors want (한의사들이 원하는 한의학 지식체계에 대한 고찰)

  • Son, Mi-Ju;Kim, Wu-Young;Jerng, Ui-Min;Park, Hwang-Jin;Han, Chang-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.16 no.3
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    • pp.89-105
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    • 2012
  • Objectives : This study was carried out to know the status of clinical utilization of Korean medical knowledge and the Korean medical knowledge system which Korean medical doctors want. Methods : Questionnaires were distributed to Korean medical doctors registered for the Association of Korean medicine via the email and 249 answered questionnaires were analyzed. Results : 50.6 % of Korean medical doctors utilized the textbooks for Korean medicine when they treated their patients. The reason why they did not utilize the textbooks for Korean medicine was mostly that 'it could not be applied directly into clinical application with only contents of textbook because clinical approach (diagnosis and treatment methods) was not clearly described in the textbook'. 48.6 % of Korean medical doctors utilized the EBM materials when they treated their patients. EBM materials that they referred included domestic articles, other EBM materials excluding papers and international academic papers based on PubMed in order. The reasons why they did not utilize the EBM materials were mostly that 'it was difficult to find the evidence' and 'EBM materials were not actually helpful for the clinical practice.' It was found that Korean medical doctors approached the disease in aspects of Korean and Western Medicine concurrently upon the diagnosis of patients and performed the diagnosis and treatment of Korean medicine on the diseases which seemed to be effective with Korean medicine. It was also found that they thought that they needed to know the Western medical knowledge as much as general doctors who have a doctor's license or family medicine specialists who comprehensively treat the general diseases know. Korean medical doctors wanted to have the systematic summary of modern research performance in fields of acupoint, acupuncture, herbal drugs and formula. They thought that constitutional medicine and Sa-am acupuncture therapy were representative characteristics in Korean medicine differentiated from Traditional Chinese medicine and Kampo medicine. Conclusions : Korean medical doctors wanted to establish the Korean medical knowledge system based on evidence focusing on clinical and practical contents. New Korean medical knowledge system should be established based on these requirements in the future.

A Diagnostic Study on High School Students' Health and Quality of Life - Based on the PRECEDE model - (고등학생의 건강 및 삶의 질에 대한 진단적 연구 - PRECEDE 모형을 근간으로 -)

  • Yoo Jae-Soon;Hong Yeo-Shin
    • The Journal of Korean Academic Society of Nursing Education
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    • v.3
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    • pp.78-98
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    • 1997
  • Health education, as the most fundamental concept for national health promotion, alms for developing the self-care ability of the general public. High school days are regarded as the period when most important physical, mental and social developments occur, and most health-related behaviors are formed. School health education is one of the major learning resources influencing health potential in the home and community as well as for the individual student. High school health education in Korea has a fundamental systemic flaw in that health-related subjects are divided and taught under various subjects areas at school. In order to achieve the goal of school health education, it is essential to make a systematic assessment of the learner's concerns connected with his health and life, and the factors affecting them. So far, most of the research projects that had been carried out for improving high school health education were limited in their concerns to a particular aspect of health. Even though some had been done in view of comprehensive school health education, they failed to Include a health assessment of the learner. Therefore, in this study the high school students' concerns related to health and life were investigated in the first place on the basis of the PRECEDE model, developed by Green and others for the purpose of a comprehensive diagnostic research on high school health education. This study was done in two steps : one was the basic study for developing research instrument and the other was the main one. The former was conducted at five high schools in Seoul and Cheongju for 2 months-beginning in March, 1996. The students were asked to respond to questions related to their health and lives in unstructured open-ended question forms. On the basis of analysis of the basic study, the diagnostic instruments for the quality of life, health problems, health behavior and educational factors were constructed to be used for the collection of data for main study. An expert panel and the pilot study were used to improve content validity and reliability of the instruments. The reliability of the instruments was measured at between .7697 and .9611 by the Cronbach $\alpha$. The data for this study were collected from the sample consisted of the junior and senior classes of twenty general and vocational high schools in Seoul and Cheongju for two months period beginning in July, 1996. In analyzing the data, both t-test and $X^2$-test were done by using SAS-$PC^+$ Program to compare data between the sexes of the high school students and the types of high school. A canonical correlation analysis was carried out to determine the relationships among the diagnostic variables, and a multivariate multiple regression analysis was conducted by using LISREL 8.03 to ascertain the influences of variables on the high school students' health and quality of life. The results were as follows : 1) The findings of the hypothesis tests (1) The canonical correlation between the educational diagnosis variables and behavioral, epidemiological, social diagnosis variables was .7221, which was significant at the level of p<.001. (2) The canonical correlation between the educational diagnosis variables and the behavior variables was .6851, which also was significant (p<.001). (3) The canonical correlation between the behavioral diagnosis variables and the epidemiological variables was 4295, which was significant (p<.001). (4) The canonical correlation between the epidemiological diagnosis variables and the social variables was .6005, which was also significant (p<.001). Therefore, the relationship between each diagnosis variable suggested by the PRECEDE model had been experimentally proven to be valid, supporting the conceptual framework of the study as appropriate for assessing the multi-dimensional factors affecting high school students' health and quality of life. Health behavior self-efficacy, the level of parents' interest and knowledge of health, and the level of the perception of school health education, all of which are the educational diagnostic variables, are the most influential variables in students' health and quality of life. In particular, health behavior self-efficacy, a causative factor, was one of the main influential variables in their health and quality of life. Other diagnostic variables suggested in the steps of the PRECEDE model were found to have reciprocal relations rather than a unidirectional causative relationship. The significance of this research is that it has diagnosed the needs of high school health education by the learner-centered assessment of variety of factors related to the health and the life of the students. This research findings suggest an integrated system of school health education to be contrived to enhance the effectiveness of the education by strengthening the influential factors such as self-efficacy to improve the health and quality of the lives of high school students.

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Clinical Characteristics of Headache in Orofacial Pain Patients (구강안면통증 환자에서의 두통 양상의 분류)

  • Kang, Jin-Kyu;Ryu, Ji-Won;Kim, Seong-Taek;Choi, Jong-Hoon
    • Journal of Oral Medicine and Pain
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    • v.31 no.4
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    • pp.355-364
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    • 2006
  • Headache is a common disease which influences not only individually but also socially. Temporomandibular disorders(TMD) refers to pain and dysfunction within the temporomandibular joint(TMJ) and associated muscles. TMD is presented commonly, and 70% of population are found to have one or more related symptom. A number of studies have been conducted to verify the association between headache and TMD, and some authors have proposed that headache and TMD may be related. In this study, we studied the patterns of headache presented by the patients who visited the TMJ and Orofacial pain clinic. Among the patients participated in this study, tension type headache showed the highest prevalence(48.5%), followed by migraine without aura(15.0%), probable migraine(10.6%), migraine with aura(7.1%), probable tension type headache(4.8%), and other primary headaches(1.8%). The high prevalence of tension type headache may be due to the accompaniment of orofacial pain by pericranial muscle tenderness. Comparison of sex showed that the rate of migraine was higher in female than male(female to male ratio 35.8:25.3). In age analysis, the rate of migraine was high in the twenties(42.2%) and the thirties(40.0%). As the age increased, the rate of migraine decreased, and this trend was in accordance with the previous studies. The percentage of the patients who had previously received treatment was only 26.2%, and that of those who were aware of the diagnosis was merely 8.7%. Therefore, it is not common for headache patients to get treatment, however, since orofacial pain is often accompanied by headache, more systematic diagnosis as well as precise treatment would be necessary. Moreover, since TMD could induce and aggravate headache, proper evaluation and management of TMD would be essential for diagnosis and treatment of headache. In the future, more systematic and broad investigation on the influence of causative factors of TMD on headache as well as the change in headache pattern with the treatment of TMD would be required.

Development of a Diagnosis Manual to Evaluate the Pedestrian Safety in a Neighborhood Using the Mixed Research Method (혼합연구방법을 활용한 근린환경의 보행안전성 진단 매뉴얼 개발)

  • Kim, Jaecheol
    • Journal of Digital Convergence
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    • v.15 no.8
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    • pp.1-14
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    • 2017
  • This study is a descriptive and exploratory one aiming to develop a systematic/diagnostic manual that is necessary for the improvement of the pedestrian safety of a neighborhood and show the practical application and usefulness of the manual through a case study. The diagnostic manual developed on the basis of the previous research review adopted a mixed research method including three investigation tools of map/data analysis using secondary data, field observation by investigators, and resident survey interview. In the case study applying the manual to Changsin-dong, Seoul, the author analyzed the results of the three investigations in integrative ways and showed the usefulness of the manual by systematically deriving the places prone to pedestrian-vehicle accidents and the influencing factors. This study contributes to the practical field in that it provides planners with a systematic tool to diagnose the pedestrian safety in the neighborhood environment while it contributes to the academic field in that it provides the concrete process that empirically compares the differences between different environmental investigative methods and deduce integrative implication from them. In a follow-up study, the author plan to apply the diagnostic manual presented in this study to more cases and improve them to work in various contexts.

A Systematic Review of Effects on Sensory Integration Intervention Based on Vestibular-Proprioceptive System for Children in Korea (아동의 전정-고유감각 중심의 감각통합중재 효과에 대한 체계적 고찰: 국내연구를 중심으로)

  • Park, Youngju;Kong, In-Joo
    • The Journal of Korean Academy of Sensory Integration
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    • v.13 no.2
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    • pp.53-61
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    • 2015
  • Objective : The purpose of this study was to investigate the effects on sensory integration interventions for korean children which focused on vestibular - proprioceptive system. Methods : Authors systematically searched published studies in DBpia, KISS and RISS databases from August to September 2015. Key words in the search were 'sensory integration intervention', 'sensory integration therapy' and 'vestibular-proprioceptive'. By using the inclusion and exclusion criteria, we selected seven studies for further analyses examining level of evidence and methodological qualities. Information for the analyses were on study designs, participants, interventions, outcome measures and results. Results : Grade IV rated evidence was found from five studies, and Grade III and Grade V rated evidence was found from one for each study. The methodological levels of the quantitative studies were 'fair' (2) and 'poor' (5). Subjects for the studies were developmental delay (5), Asperger Syndrome (1), and not specific diagnosis (2). Single-subject design was most frequently used and motor area were most frequently evaluated. The interventions used the studies showed positive effects on outcome measures. Conclusion : This study presented the summary of sensory integration intervention based on vestibular-proprioceptive system for Korean children. More studies with high level of evidence and various study designs need to be followed.

A Systematic Review of Sensory Integration Intervention for Children in Korea (아동을 대상으로 한 감각통합치료의 중재효과에 대한 체계적 고찰: 국내 연구를 중심으로)

  • Hong, Eunkyoung
    • The Journal of Korean Academy of Sensory Integration
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    • v.18 no.2
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    • pp.55-68
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    • 2020
  • Objective : The purpose of this study is to summarize the best-available intervention evidence for children's sensory integration therapy, drawn from studies published domestically in Korea over the last 10 years. Methods : The articles evaluated in this study were collected from the RISS and DBpia databases using the search terms "sensory integration," "sensory processing," and "Ayres Sensory Integration (ASI)". A total of 19 papers were analyzed. The selected studies were then assessed using the Population, Intervention, Outcomes, and Comparison method, the International Classification of Functioning, Disability and Health (ICF) method, and the modified Evidence Alert Traffic Light Grading System. Results : Development delay was the most commonly applied diagnosis for children's sensory integration therapy and individual sensory integration therapy was the most frequently used intervention method. The intervention effect was 91 percent in the body structure and function of ICF. The areas concentrated on were sensory modulation, sensory processing, fine and gross motor, body scheme, body-self concept, balance, basic movement, postural control and hand function, attention, and self-esteem. Conclusion : This simple overview of the efficacy of children's sensory integration therapy provides a basis for easy understanding and use by therapists, researchers and families with children.

Sarcopenia and Smoking: Systematic Review and Meta-analysis (근감소증과 흡연: 체계적 문헌고찰 및 메타분석)

  • Kim, Su Kyung;Shin, Yeong Hee;Kim, Gaeun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.273-284
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    • 2017
  • This study performed meta-analysis of published articles to examine the relationship between sarcopenia and smoking. We searched the PubMed, EMBASE, Cochrane library, and RISS database sup to January 2017 using search terms such as sarcopenia AND (smoking OR tobacco OR cigarette). A total of 25 articles were included in the analysis (seven cohort studies and 18 cross-sectional studies). Incidence of sarcopenia in smokers and non-smokers was analyzed by the random effects model. Incidence of sarcopenia was OR 1.49 (95% CI 1.21, 1.84, p<.001, I2 = 88.20%), Asian (OR 1.28, 95% CI 0.91, 1.78, p=0.150, I2=85.32%), and Western (OR 1.65, 95% CI 1.25, 2.17, p<.001, I2=91.08%), Western smokers showed a significantly higher incidence of sarcopenia:males and females with OR 1.25(95% CI 1.11, 1.40, p<.001, 12=87.4%) and 1.80(95% CI 0.98, 3.30, p=.057, 12=89.1 %) respectively. Male smokers showed significantly higher incidence of sarcopenia. Based on the results of the study, smoking in Western males is related to sarcopenia. However, since the criteria for the diagnosis of sarcopenia and the criteria for smoking were different, cumulative individual clinical studies applying uniform assessment for the evaluation of sarcopenia and smoking status are needed in the future.